Application of ultrasound-guided fine-needle aspiration biopsy plus detection of BRAF V600E mutations to diagnose TI-RADS4-5 thyroid nodules
ZHU Yuanfeng
WANG Pei
LIU Yuan
Abstract：Objective To explore the application value of ultrasound guided fine-needle aspiration biopsy(US-FNAB)plus detection of v-raf murine sarcoma viral oncogene homolog B1(BRAF)V600E mutations in the diagnosis of thyroid nodules with thyroid imaging reporting and data system(TI-RADS)grade 4-5.Methods A total of 150 patients with thyroid nodules confirmed by ultrasonography examined in our hospital from August 2021 to August 2023 were included in the study.They were examined by US-FNAB+BRAF V600E mutation detection.Using the clinicopathological results as the gold standard,the clinical value of the single examination of the US-FNAB and BRAF V600E mutation test,and their combined detection in the diagnosis of TI-RADS 4-5 thyroid nodules was compared.Results There were 189 thyroid nodules in 150 patients.Pathological diagnosis confirmed 87(46.03％)malignant nodules and 102(53.97％)benign nodules.BRAF V600E test results showed 49(25.93％)positive and 140(74.07％)negative cases.US-FNAB test results showed 72(38.10％)positive,and117(61.90％)negative cases.The sensitivity,specificity and accuracy of US-FNAB in the diagnosis of TI-RADS 4-5 thyroid nodules were 68.97％(60/87),88.24％(90/102)and 79.37％(150/189),respectively.Those of BRAF V600E mutation detection were 56.32％(49/87),100％(102/102),and 79.89％(151/189),respectively.Their combined diagnosis showed 82.76％(72/87)of sensitivity,96.08％(98/102)of specificity and 89.95％(170/189)of accuracy.The sensitivity and accuracy of combined diagnosis were the highest(P＜0.05),and the specificity of BRAF V600E mutation detection was the highest.US-FNAB combined with BRAF V600E mutation detection had the highest clinical value in the diagnosis of TI-RADS 4-5 thyroid nodules,with the area under the curve(AUC)of 0.894(95％CI 0.841-0.934).The AUC of BRAF V600E mutation detection and US FNAB diagnosis alone was 0.782(95％CIO.716-0.838)and 0.786(95％CI 0.721-0.842),respectively.Conclusion The US-FNAB combined BRAF V600E mutation detection method has high value in clinical practice,which helps to improve the accurate judgment of benign and malignant thyroid nodules.
Keywords：thyroid imaging reporting and data system(TI-RADS)classificationv-raf murine sarcoma viral oncogene homolog B1(BRAF)V600E mutationultrasound guided fine-needle aspiration biopsy(US-FNAB)combined diagnosis
Publication Date：2025-07-26
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1147-1150 )